Resumo Objetivo Investigar a prevalência e os fatores associados à depressão e ansiedade entre profissionais de saúde durante a pandemia de COVID-19 no extremo sul do Brasil. Método Estudo transversal realizado com 264 profissionais de saúde, entre agosto e dezembro de 2020. Depressão e ansiedade foram avaliadas por meio do Questionário de Saúde do Paciente e da Escala de Ansiedade Generalizada. Foi realizada análise de regressão linear multivariável. Resultados A prevalência de depressão e ansiedade entre os profissionais de saúde foi de 32,4% e 26,2%, respectivamente. Ser técnico de enfermagem, ter familiar que tenha perdido o emprego, ser responsável pela renda familiar, ter 50 anos ou mais, ser divorciado/viúvo, ter feito exame para COVID-19, ter sofrido evento traumático na vida e ter recebido aconselhamento psicológico no trabalho esteve associado a depressão e ansiedade. Conclusão Neste estudo, receber aconselhamento psicológico no trabalho foi um fator de proteção para ansiedade e depressão. COVID19 COVID 19 COVID-1 Brasil 26 2020 Generalizada multivariável 324 32 4 32,4 262 2 26,2% respectivamente enfermagem emprego 5 mais divorciadoviúvo divorciado viúvo divorciado/viúvo COVID19, 19, estudo COVID1 1 COVID- 202 3 32, 26,2 20 26,

Abstract Objective To investigate the prevalence and associated factors of depression and anxiety among hospital healthcare workers during the COVID-19 pandemic in the extreme south of Brazil. Method Cross-sectional study was conducted with 264 healthcare workers, between August and December 2020. Depression and anxiety were assessed using the Patient Health Questionnaire and the Generalized Anxiety Scale. Multivariable linear regression analysis was performed. Results The prevalence of depression and anxiety among healthcare workers was 32.4% and 26.2%, respectively. The profession of nursing technician, having a family member who had lost a job, being responsible for family income, being 50 or more years old, being divorced or widowed, having a test for COVID-19, having suffered a traumatic event in life and having received psychological counseling at work were associated with depression and anxiety. Conclusion In this study, receiving psychological counseling at work was a protective factor for anxiety and depression. COVID19 COVID 19 COVID-1 Brazil Crosssectional Cross sectional 26 2020 Scale performed 324 32 4 32.4 262 2 26.2% respectively technician job income 5 old widowed COVID19, 19, COVID1 1 COVID- 202 3 32. 26.2 20 26.

RESUMEN Objetivo: conocer las prácticas de cuidados prestados por las enfermeras a las personas con tuberculosis en la Estrategia de Salud de la Familia. Método: investigación cualitativa descriptiva realizada con 11 enfermeros de unidades de salud familiar de Rio Grande, RS - Brasil, en el primer semestre de 2021. La invitación se hizo por teléfono y se programó una entrevista en línea. Los datos fueron analizados de acuerdo con el análisis de contenido. Resultados: se evidenciaron tres categorías: Prácticas relacionadas con los cuidados de enfermería: obstáculos y concepciones erróneas, (Rel)Acciones en los cuidados de enfermería al usuario con TB, (Re)Pensamiento sobre las orientaciones dadas al usuario. Las prácticas de cuidados se basaron en el vínculo y en la acogida al usuario. Sin embargo, hubo malentendidos en las orientaciones y obstáculos en el afrontamiento de la enfermedad. Se observó un cambio en la conducta y percepción de la enfermedad ante la pandemia del Covid-19. Conclusión: Las buenas prácticas asistenciales, tanto relacionales como técnicas, se ven atravesadas por dificultades, ya sean internas o externas a la unidad. Objetivo Familia Método 1 Grande Brasil 2021 línea contenido Resultados categorías erróneas RelAcciones Rel Acciones TB RePensamiento Re Pensamiento embargo Covid19. Covid19 Covid 19. 19 Covid-19 Conclusión asistenciales técnicas dificultades unidad 202 Covid1 Covid-1 20 Covid- 2

RESUMO Objetivo: conhecer as práticas de cuidado prestadas por enfermeiras às pessoas com tuberculose na Estratégia Saúde da Família. Método: pesquisa qualitativa descritiva, realizada com 11 enfermeiras de unidades de saúde da família do Rio Grande, RS - Brasil, no primeiro semestre de 2021. O convite ocorreu por telefonema, sendo agendada entrevista online. Os dados foram analisados segundo análise de conteúdo. Resultados: evidenciaram-se três categorias; Práticas relacionadas ao cuidado de enfermagem: obstáculos e equívocos, (Rel)Ações no cuidado de enfermagem ao usuário com TB, (Re)Pensando sobre as orientações prestadas ao usuário. As práticas de cuidado, pautavam-se no vínculo e no acolhimento ao usuário. Todavia, houve equívocos nas orientações e obstáculos no enfrentamento da doença. Foi observado modificação nas condutas e na percepção sobre a doença diante da pandemia de Covid-19. Conclusão: as boas práticas de cuidado, relacionais e técnicas, são atravessadas por dificuldades, sejam internas ou externas à unidade. Objetivo Família Método descritiva 1 Grande Brasil 2021 telefonema online conteúdo Resultados evidenciaramse evidenciaram se categorias RelAções Rel Ações TB RePensando Re Pensando pautavamse pautavam Todavia Covid19. Covid19 Covid 19. 19 Covid-19 Conclusão técnicas dificuldades unidade 202 Covid1 Covid-1 20 Covid- 2

ABSTRACT Objective: to understand the care practices provided by nurses to people with tuberculosis in the Family Health Strategy. Method: descriptive qualitative research, carried out with 11 nurses from family health units in the Rio Grande, RS - Brazil, in the first semester of 2021. The invitation was made by telephone and an online interview was scheduled. The data were analyzed according to content analysis. Results: three categories were evidenced; Practices related to nursing care: obstacles and misconceptions, (Rel)Actions in nursing care for the user with TB, (Re)Thinking about the guidelines provided to the user. The care practices were based on the bond and on welcoming the user. However, there were misunderstandings in the guidelines and obstacles in coping with the disease. A change was observed in the conduct and perception about the disease in the face of the Covid-19 pandemic. Conclusion: good care practices, both relational and technical, are crossed by difficulties, whether internal or external to the unit. Objective Strategy Method research 1 Grande Brazil 2021 scheduled analysis Results evidenced misconceptions RelActions Rel Actions TB ReThinking Re Thinking However Covid19 Covid 19 Covid-1 pandemic Conclusion technical difficulties unit 202 Covid1 Covid- 20 2

Abstract Infection disease caused by nontuberculous mycobacteria (NTM) have been increasingly reported and often manifest with the same symptoms of tuberculosis (TB). The identification of the causative agent is fundamental for the determination of an appropriate therapy, since each species of mycobacteria requires a specific treatment. Thus, rapid and accurate tests to identify mycobacteria of medical interest, such as Mycobacterium tuberculosis complex (MTBC) and Mycobacterium avium complex (MAC), are necessary in the clinical routine. The present study evaluated an in-house multiplex PCR to detect, in reference and clinical strains, the genus Mycobacterium and also M. tuberculosis and MAC. To identify the Mycobacterium genus, M. tuberculosis and MAC, it was amplified a fragment of hsp65 gene, esat-6 gene, and the internal transcribed spacer between the 16S and 23S rRNA genes, respectively. In total, 87 mycobacteria strains were used, being 10 reference and 77 clinical strains, previously identified as MTBC (n = 66), M. avium (n = 8) or other NTM specie (n = 13). The hsp65 gene fragment was amplified for all mycobacteria strains evaluated (87/87). This multiplex PCR presented sensitivity of 100% and specificity of 95.2% for M. tuberculosis detection, and sensitivity of 100% and specificity of 100% for MAC detection. The multiplex PCR evaluated is an important tool for the differentiation between M. tuberculosis and NTM, as well as for the identification of MAC, a complex composed by species with high prevalence in the world. (NTM TB. TB . (TB) therapy treatment Thus interest (MTBC , (MAC) routine inhouse house detect M hsp hsp6 esat6 esat 6 esat- S genes respectively total 8 used 1 7 n 66, 66 66) 13. 13 13) 87/87. 8787 87/87 (87/87) 100 952 95 2 95.2 detection world (TB (MAC 878 87/8 (87/87 9 95. 87/ (87/8 (87/ (87 (8 (

Resumo A tuberculose (TB) apresenta incidências elevadas em todo o mundo, sendo ainda mais grave em pessoas privadas de liberdade (PPL). Foi avaliada a completude das notificações de TB de PPL no SINAN realizadas por equipes de atenção primária prisional (eAPP) ou por outros estabelecimentos de saúde do RS. Estudo descritivo, transversal, utilizando dados de notificações de PPL feitas no SINAN TB pelas eAPP ou por outros estabelecimentos de saúde, de janeiro de 2014 a novembro de 2018. Foi analisado o percentual de completude das variáveis: sexo, raça/cor, escolaridade, HIV, tipo de entrada, baciloscopia de escarro, cultura do escarro, Aids, tratamento antirretroviral durante o tratamento para a TB, tratamento diretamente observado (TDO), baciloscopia de 6º mês e situação de encerramento. Praticamente 53% dos casos de TB em PPL foram notificados por eAPP, e 47,1% foram notificados por outros estabelecimentos de saúde. Oitenta por cento das variáveis foram classificadas na categoria 4 (75,1% a 100% de completude). No entanto, as variáveis TDO e baciloscopia de 6º mês foram classificadas na categoria 3 (50,1% e 75% de completude). Embora não comprometa a notificação da TB no SINAN, a ausência de dados pode prejudicar a qualidade das informações sobre a doença.

Abstract Tuberculosis (TB) has a high incidence in several countries and is even more severe in prisoners. We evaluated the completeness of prisoners TB notifications in the Notifiable Disease Information System (SINAN) carried out by prison primary care teams (eAPP) or by other health facilities in the state of Rio Grande do Sul (RS). This descriptive cross-sectional study used prisoners data notifications in the SINAN TB by the eAPP or other health facilities from January 2014 to November 2018. We analyzed the percentage of completeness of the variables: gender, ethnicity, schooling, HIV, entry type, sputum smear, sputum culture, AIDS, ART during TB treatment, directly observed treatment (DOT), sixth-month smear, and closure status. Around 52.9% of TB cases in prisoners were reported by eAPP, and other health facilities reported 47.1% of the cases. Eighty percent of the variables were classified in category 4 (75.1% to 100% completeness). However, the DOT and sixth-month smear variables were classified into category 3 (50.1% and 75% completeness). While it does not compromise the notification of TB in the SINAN, the lack of data can impair the quality of information about the disease.

ABSTRACT Tuberculosis (TB) is a serious infectious disease, and its control is considered a challenge, especially among vulnerable populations such as prisoners. The occurrence of TB in prisons is an alarming public health problem in many countries. This integrative review aims to describe the epidemiology of TB and control strategies for this disease in countries with the largest prison populations. Studies have shown that it is essential to know the prevalence of TB in prisons of each country. This is because it can serve as an indication of the need for action in prisons to reduce TB rates, including improving the structure of prison environments, rapidly and accurately diagnosing new cases, identifying drug-resistant strains, and implementing effective and directly observed treatment for TB.

ABSTRACT Background: Tuberculosis is a worldwide public health problem and is more prevalent in specific populations, such as prisoners. The aim of this study was to analyze the epidemiological and operational indicators of tuberculosis in prisoners in a southern region of Brazil. Methods: This was a descriptive, observational study, utilizing secondary data from the Notifiable Diseases Information System on tuberculosis cases diagnosed in prisoners in the state of Rio Grande do Sul, southern Brazil, from 2014 to 2018. Prisoner data used to calculate incidence were extracted from reports by the National Penitentiary Department. Results: From 2014 to 2018, 3,557 tuberculosis cases were reported in Rio Grande do Sul prisoners. The incidence rate of tuberculosis in prisoners was 1,235/100,000 individuals in 2014 and 1,430/100,000 individuals in 2018. The proportion of new TB cases tested for HIV was high, 83.4% in this period; among those tested, 12.9% were HIV coinfected. The proportion of new cases of pulmonary tuberculosis confirmed by laboratory criteria was 52.6% in this period. In total, 18.4% of new pulmonary tuberculosis cases were initiated on directly observed treatment in this period, and 36.4% of contacts of new cases of pulmonary tuberculosis with laboratory confirmation were examined. Among retreatment pulmonary tuberculosis cases, 82.4% were laboratory-confirmed. Conclusions: Tuberculosis incidence is increasing on a per-capita and absolute basis in Rio Grande do Sul. Laboratory confirmation, HIV testing, directly observed treatment, and contact investigation rates were all low, indicating the need to improve medical and public health measures for tuberculosis control in prisons.

ABSTRACT Background: Tuberculosis (TB) remains a serious public health problem, with approximately 10 million new cases reported annually. Knowledge about the quantitative evolution of theses and dissertations (T&Ds) examining human TB in Brazil can contribute to generating strategic planning for training professionals in this field and disease control. Therefore, this study highlights the role of T&Ds on TB in national scientific disclosures. Methods: An integrative review related to TB was performed, including T&Ds produced in Brazil and completed between 2013 and 2019. Results: A total of 559,457 T&Ds were produced, of which 1,342 were associated with TB, accounting for 0.24% of the total number of T&Ds in Brazil. This was evidenced by a predominance of themes such as attention/health care, epidemiology, and TB treatment, and 80.2% of the T&Ds on TB were related to the large areas of health and biological sciences. Only 19.7% of T&Ds were associated with groups of patients considered at risk for TB, and 50.9% were produced in southeastern Brazil. The 1,342 T&Ds on TB were developed in 416 postgraduate programs linked to 121 higher education institutions (HEIs). We highlight that 72.7% of T&Ds on TB were produced in federal HEIs, 27.4% in state HEIs, and 8.5% in private HEIs. Conclusions: Strategic themes, such as TB control, require public policies that aim to increase the number of doctors and masters with expertise in TB, with geographic uniformity, and in line with the priorities for disease control.

Abstract Tuberculosis (TB) has a high incidence in several countries and is even more severe in prisoners. We evaluated the completeness of prisoners TB notifications in the Notifiable Disease Information System (SINAN) carried out by prison primary care teams (eAPP) or by other health facilities in the state of Rio Grande do Sul (RS). This descriptive cross-sectional study used prisoners data notifications in the SINAN TB by the eAPP or other health facilities from January 2014 to November 2018. We analyzed the percentage of completeness of the variables: gender, ethnicity, schooling, HIV, entry type, sputum smear, sputum culture, AIDS, ART during TB treatment, directly observed treatment (DOT), sixth-month smear, and closure status. Around 52.9% of TB cases in prisoners were reported by eAPP, and other health facilities reported 47.1% of the cases. Eighty percent of the variables were classified in category 4 (75.1% to 100% completeness). However, the DOT and sixth-month smear variables were classified into category 3 (50.1% and 75% completeness). While it does not compromise the notification of TB in the SINAN, the lack of data can impair the quality of information about the disease.

Resumo A tuberculose (TB) apresenta incidências elevadas em todo o mundo, sendo ainda mais grave em pessoas privadas de liberdade (PPL). Foi avaliada a completude das notificações de TB de PPL no SINAN realizadas por equipes de atenção primária prisional (eAPP) ou por outros estabelecimentos de saúde do RS. Estudo descritivo, transversal, utilizando dados de notificações de PPL feitas no SINAN TB pelas eAPP ou por outros estabelecimentos de saúde, de janeiro de 2014 a novembro de 2018. Foi analisado o percentual de completude das variáveis: sexo, raça/cor, escolaridade, HIV, tipo de entrada, baciloscopia de escarro, cultura do escarro, Aids, tratamento antirretroviral durante o tratamento para a TB, tratamento diretamente observado (TDO), baciloscopia de 6º mês e situação de encerramento. Praticamente 53% dos casos de TB em PPL foram notificados por eAPP, e 47,1% foram notificados por outros estabelecimentos de saúde. Oitenta por cento das variáveis foram classificadas na categoria 4 (75,1% a 100% de completude). No entanto, as variáveis TDO e baciloscopia de 6º mês foram classificadas na categoria 3 (50,1% e 75% de completude). Embora não comprometa a notificação da TB no SINAN, a ausência de dados pode prejudicar a qualidade das informações sobre a doença.

RESUMO Objetivo: As micobactérias não tuberculosas (MNT) são um grupo heterogêneo de bactérias amplamente distribuídas na natureza e relacionadas com infecções oportunistas em seres humanos. Os objetivos deste estudo foram identificar MNT em pacientes com suspeita de tuberculose e culturas positivas e avaliar a diversidade genética de cepas identificadas como Mycobacterium avium. Métodos: Foram estudadas amostras pulmonares e extrapulmonares provenientes de 1.248 pacientes. As amostras que apresentaram resultado positivo em cultura e negativo para o complexo M. tuberculosis na identificação molecular foram avaliadas por meio da detecção dos genes hsp65 e rpoB e de sequenciamento de fragmentos conservados desses genes. Todas as cepas identificadas como M. avium foram genotipadas pelo método mycobacterial interspersed repetitive unit-variable-number tandem-repeat com oito loci. Resultados: Das 332 micobactérias isoladas, 25 (7,5%) eram MNT. Dessas 25, 18 (72%) eram M. avium, 5 (20%) eram M. abscessus, 1 (4%) era M. gastri e 1 (4%) era M. kansasii. As 18 cepas de M. avium apresentaram alta diversidade, e apenas duas eram geneticamente relacionadas. Conclusões: Esses resultados mostram a necessidade de considerar a investigação de MNT em pacientes com suspeita de tuberculose ativa e culturas positivas e de avaliar a diversidade genética de cepas de M. avium.

ABSTRACT Objective: Nontuberculous mycobacteria (NTM) are a heterogeneous group of bacteria that are widely distributed in nature and associated with opportunistic infections in humans. The aims of this study were to identify NTM in patients with suspected tuberculosis who presented positive cultures and to evaluate the genetic diversity of strains identified as Mycobacterium avium. Methods: We studied pulmonary and extrapulmonary samples obtained from 1,248 patients. The samples that tested positive on culture and negative for the M. tuberculosis complex by molecular identification techniques were evaluated by detection of the hsp65 and rpoB genes and sequencing of conserved fragments of these genes. All strains identified as M. avium were genotyped using the eight-locus mycobacterial interspersed repetitive unit-variable-number tandem-repeat method. Results: We found that NTM accounted for 25 (7.5%) of the 332 mycobacteria isolated. Of those 25, 18 (72%) were M. avium, 5 (20%) were M. abscessus, 1 (4%) was M. gastri, and 1 (4%) was M. kansasii. The 18 M. avium strains showed high diversity, only two strains being genetically related. Conclusions: These results highlight the need to consider the investigation of NTM in patients with suspected active tuberculosis who present with positive cultures, as well as to evaluate the genetic diversity of M. avium strains.

ABSTRACT In this study, we evaluated the mutations of Helicobacter pylori associated with resistance to clarithromycin and levofloxacin. Furthermore, based on the proposed interaction between antimicrobial resistance and pathogenicity, we correlated the mutation profiles of the strains with the presence of the pathogenicity gene cagA. We analyzed 80 gastric biopsy specimens from H. pylori-infected patients for point mutations in the 23S rRNA gene region and in the gyrA gene, which are related to clarithromycin and levofloxacin resistance, respectively, and investigated the presence of the cagA gene in these strains. We observed that in the assayed biopsies, 8.7% (7/80) had mutations in the 23S rRNA gene region at positions 2143 and 2142, while 22.5% (18/80) had mutations in gyrA at codons 87 and 91. Moreover, absence of the CagA-EPIYA pathogenicity factor was observed in 68% (17/25) of resistant samples. The knowledge of the local profile of antimicrobial resistance and the complex interplay involving resistance and pathogenicity can contribute to an appropriate clinical approach.

RESUMO Contexto Helicobacter pylori tem uma distribuição a nível mundial, e está associado a patogênese de várias doenças do sistema digestivo. O tratamento para a erradicação deste microrganismo envolve a utilização de uma combinação de agentes antimicrobianos, tais como amoxicilina, metronidazol, claritromicina e levofloxacino, combinados com inibidores da bomba de prótons. Embora a terapia atual seja eficaz, uma elevada taxa de fracasso de tratamento tem sido observada, principalmente devido à aquisição de mutações pontuais, um dos principais mecanismos de resistência desenvolvida por H. pylori, relacionado com o uso frequente e/ou inadequado dos antibióticos. Conclusão Esta revisão abordou uma visão geral da resistência às principais drogas utilizadas no tratamento de H. pylori, confirmando a hipótese de que a resistência bacteriana é um fenômeno altamente local e as características genéticas de uma dada população podem influenciar qual terapia é a mais apropriada.

ABSTRACT Background Helicobacter pylori has a worldwide distribution and is associated with the pathogenesis of various diseases of the digestive system. Treatment to eradicate this microorganism involves the use of a combination of antimicrobials, such as amoxicillin, metronidazole, clarithromycin, and levofloxacin, combined with proton pump inhibitors. Although the current therapy is effective, a high rate of treatment failure has been observed, mainly because of the acquisition of point mutations, one of the major resistance mechanisms developed by H. pylori. This phenomenon is related to frequent and/or inappropriate use of antibiotics. Conclusion This review reported an overview of the resistance to the main drugs used in the treatment of H. pylori, confirming the hypothesis that antibacterial resistance is a highly local phenomenon and genetic characteristics of a given population can influence which therapy is the most appropriate.

IntroductionHelicobacter pylori infection is associated with gastro-duodenal diseases. Genes related to pathogenicity have been described for H. pylori and some of them appear to be associated with more severe clinical outcomes of the infection. The present study investigates the role of cagE as a pathogenicity biomarker of H. pylori compare it to cagA, vacA, iceA and babA2 genes and correlate with endoscopic diagnoses.MethodsWere collected biopsy samples of 144 dyspeptic patients at the Hospital of the Federal University of Rio Grande, Rio Grande do Sul, Brazil. After collection, the samples were sent for histological examination, DNA extraction and detection of all putative pathogenicity genes by PCR.ResultsOf the 144 patients undergoing endoscopy, 57 (39.6%) presented H. pylori by histological examination and PCR by detection of the ureA gene. Based on the endoscopic diagnoses, 45.6% (26/57) of the patients had erosive gastritis, while 54.4% (31/57) had enanthematous gastritis. The genes cagA, cagE, vacAs1/m1, vacAs1/m2 and iceA1 were related to erosive gastritis, while the genes vacAs2/m2, iceA2 and babA2 were associated to enanthematous gastritis. We found a statistically significant association between the presence of cagE and the endoscopic diagnosis. However, we detect no statistically significant association between the endoscopic diagnosis and the presence of cagA, vacA, iceA and babA2, although a biological association has been suggested.ConclusionsThus, cagE could be a risk biomarker for gastric lesions and may contribute to a better evaluation of the H. pylori pathogenic potential and to the prognosis of infection evolution in the gastric mucosa.

Helicobacter pylori infects nearly 50% of the world's population. This microorganism is accepted as the most important agent of gastritis and as a risk factor for peptic ulcer disease and gastric adenocarcinoma. Currently many diagnostic methods exist for detecting H. pylori, however they all have limitations, thus it is recommend a combination of at least two methods. The aim of this study was to evaluate diagnostic methods, such as in-house urease test, culture and Polymerase Chain Reaction (PCR), for the detection of the H. pylori in gastric biopsy specimens of 144 dyspeptic patients, using as gold standard the association between histology and rapid urease test. According to the gold standard used in this study, 48 (33.3%) patients were infected with H. pylori, while 96 (66.7%) were classified as not infected. The in-house urease test and the PCR were the most sensitive methods (100%), followed by culture (85.4%). However, the in-house urease test and the culture were the most specific (100%), followed by PCR (75%). In conclusion, this study showed that, in comparison with the combination of histology and rapid urease test, the in-house urease test and the PCR presented 100% of sensitivity in the diagnosis of gastric infection by H. pylori, while the in-house urease test and the culture reached 100% of specificity. These finding suggest that the combination of two or more methods may improve the accuracy of the H. pylori detection.